DR. SOWMYA R.

Abstract

Forty-Six-year old gentleman came with squinting and diminution of vision (OU) following RTA.

K/C/O traumatic optic neuropathy (OD); S/P PPL+PPV for dislocated lens (OS); S/P multiple lid surgeries (OS) following RTA in 2007. S/P SFIOL (OS).BCVA(OD)6/30, N24; (OS) 6/12,N8 Hirschberg test showed LHT & LXT measuring 45 pd L/R with 30-35 pd XT .EOM (OS) show limited elevation of -5, abduction of -1 to -2, adduction of -1/2 AS (OD) illlsustained pupil; (OS)enophthalmos,retracted upperlid with a notch,dilated fixed pupil with IOL.Fundus examination (OD) Pale disc; (OS)Pale disc with peripapillary choroidal rupture upto fovea Visual fields (OU) temporal hemianopia .SR recession (4+4mm) by hemi hangback technique.IO was seen transposed at insertion of IR while IR was absent.Modified Nishida involving LR only was done with MR plication of 5 mm. .Partial or single muscle modified Nishida also seems to give good vertical correction and a prudent option in cases needing >3 rectus muscle surgery